Knee Periprosthetic Infections: CAOS Use in One Stage Procedures

Abstract

INTRODUCTIONThe results of TKA revisions are less good than a primary TKA (1). The TKA revision frequency increases and we must prepare the next standard of these surgeries (4).The aim of this study was to evaluate the CAOS / one stage strategy to treat the knee PJIs (2, 3).MATERIALSIn this prospective study, between September 2011 and december 2014, 41 patients treated for chronic knee PJI in a one stage revision. An imageless CAOS system (ExactechGPS, Blue-Ortho, Gieres) was used with a personnalized profile. All surgeries were performed with the same protocole and by using the same Optetrak CC knee components (Exactech, Gainesville, FL). All operations were performed by a single senior surgeon.Indications for the revision TKA were (1) revision of a primary TKA or unicondylar knee arthroplasty (n=27) or (2) revision of revisionTKA (n=15). The measurement of the HKA angle, the Oxford score and the ROM were evaluated pre and post-operatively.

RESULTS27 males and 14 females with an average age of 71 years old (55-87) were treated for a PIJ (1 unicompartimental prosthesis, 26 TKA and 15 RTKA). The mean follow-up was 41 months (30 months - 6 years). The average time of surgery was 135 mn (120-195) for an average hospitalisation duration of 10 days (7-16). No postoperative outliers were reported (mean preop.: -1,6°+/_-5,1° - Post-op. -0,3°+/_ -1,4°). The average ROM were 115° (90-130°) (Fig. 1). The rate of success for the infection was 92,7%. We report no specific CAS complications and all the navigations were finalized. In this series of complex cases, the rate of infection healing is 92,7%.

DISCUSSIONUsing CAOS is a safe option with no specific complication. Combined with one stage procedures, it should be a optimal medicoeconomical strategy for Knee revisions.

This first series initiated the « GPS RTKA » project to create a dedicated software evaluated since January 2016 with immediate very good functional results and no complications. 2002;(404): 7-13